• Korean Journal of Clinical Laboratory Science
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• v.43 no.4
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• pp.188-193
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• 2011

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. Since it is closely related to sleep parameter and body indices, the study was focused on the relationship with them. The results of polysomnography (PSG) in obstructive sleep apnea was done at ENT department of Ewha women university Mokdong hospital from March to September 2010 with 52 subjects (male 35, female 17). The leads were placed to measure electroencephalogram (EEG), electrooculogram (EOG), mandibular and anterior tibialis electromyogram (EMG), airflow in nasal and oral cavity, chest and abdominal breathing pattern, snoring sound and arterial oxygen saturation ($SpO_2$) level. From sleep parameter and body indices of adult obstructive sleep apnea compared to normal adult revealed that age (p<0.01) and snoring sound (p<0.05) were increased, stage 1 sleep (p<0.01) was increased, the deeper stages (3&4) of sleep (p<0.05) were reduced. Respiratory disturbance index (RDI) (p<0.01), mean $SpO_2$ (p<0.05) and lowest $SpO_2$ (p<0.01) were also decreased. The correlation analysis from sleep parameter and body indices of OSA showed the positive correlation with age (r=0.463, p<0.001), snoring sound (r=0.278, p<0.05), stage 1 sleep (r=0.391, p<0.01) and RDI (r=0.409, p<0.01), but showed the negative correlation with the deeper stages (3&4) of sleep (r=-0.307, p<0.05), mean $SpO_2$=(r=-0.274, p<0.05) and lowest $SpO_2$ (r=-0.392, p<0.01). This study proves that obstructive sleep apnea and indices have closed related.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.561-565
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• 1990

We experienced thymolipoma which is a rare benign mediastinal tumor, an admixture of atrophic thymic tissue and matured adipose tissue. The patient was, 13 years old boy, admitted due to anterior mediastinal mass on routine chest X-ray and complained of mild exertional dyspnea. The physical examination revealed percussion dullness, decreased breathing sound at right anterior hemithorax. The chest PA and lateral views showed both paracardiac mass density and obliteration of retrosternal clear space. The chest CT Scan showed tubular structure containing of thymic tissue and enhanced fatty tissue, suggested thymolipoma. Operation was performed under the impression of thymolipoma. Through median sternotomy, the huge mass was resected. Grossly, the mass was yellowish fatty colored, measured 15X12X10cm, weighed 600gm. Light microscopic examination showed that thymic tissue containing of Hassal`s corpuscles were surrounded by matured adipose tissue, as the characteristic finding of thymolipoma. The postoperative course was uneventful.

• The Journal of the Korea institute of electronic communication sciences
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• v.17 no.3
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• pp.491-498
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• 2022

In our daily life, quality of sleeping is closely related to happiness index. Whether or not people perceive sleep disturbance as a chronic disease, people complain of many difficulties, and in their daily life, they often experience difficulty breathing during sleep. It is very important to automatically recognize breathing-related disorders during a sleep, but it is very difficult in reality. To solve this problem, this paper proposes a mobile-based non-contact sleeping monitoring for health management at home. Respiratory signals during the sleep are collected by using the sound sensor of the smartphone, the characteristics of the signals are extracted, and the frequency, amplitude, respiration rate, and pattern of respiration are analyzed. Although mobile health does not solve all problems, it aims at early detection and continuous management of individual health conditions, and shows the possibility of monitoring physiological data such as respiration during the sleep without additional sensors with a smartphone in the bedroom of an ordinary home.

• Journal of Chest Surgery
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• v.17 no.1
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• pp.118-124
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• 1984

Congenital Cystic Adenomatiod Malformation (C.C.A.M.) is rare, but one of the most common congenital pulmonary anomalies that cause acute respiratory distress in the newborn infants. It is characterized and differentiated from the diffuse pulmonary cystic disease pathologically, i.e. adenomatoid appearance due to marked proliferation of the terminal respiratory components. An 2/12 year old male patient was suffered from respiratory distress and cyanosis on crying since birth, but no specific therapy was given. With progression of symptoms, he came to Korea University Hospital for further evaluation and then transfered to Dept. of Chest Surgery for operative correction under the impression of Congenital Obstructive Emphysema suggested by a pediatrician. On gestational and family history, there was nothing to be concerned such as congenital anomaly. Physical examinations showed; moderate nourishment and development (Wt. 5.5kg), cyanosis on crying, both intercostal and lower sternal retraction on inspiration, Lt. chest building with tympany, Rt. shifting of cardiac dullness, decreased breathing sound with expiratory wheezing on entire Lt. lung field, decreased breathing sound on Rt. upper lung filed, and tachycardia. The remainders were nonspecific. Laboratory findings were normal except WBC $14000/mm^3$ (lymphocyte 70%), Hgb 9.8m%, Hct 28%, negative Mantaux test, and sinus tachycardia and counter-clockwise rotation on EKG. Preoperative simple Chest PA revealed marked hyperlucent entire Lt. lung, herniation of Lt. upper lobe to Rt., collapsed Rt. upper lobe, tracheal deviation and mediastinal shifting to Rt., and no pleural reaction. At operation, after Lt. posterolateral thoracotomy, 4th rib was resected. Operative findings were severe emphysematous changes limited to both lingular segmentectomy was done. The resected specimen showed slight solidity, measuring $8{\times}4.5{\times}2cm$ in size, and small multiple cystic spaces filled with air. Microscopically, entire tissue structures were glandular in appearance, cyst were lined by ciliated columnar epithelium, and occasional cartilages were noted around the cystic spaces. Bronchial elements were dilated but normal pattern on histologically. The patient had a good postoperative courses clinically and radiologically, and discharged on POD 10th without event. The authors report a case of Cogenital Cystic Adenomatoid Malformation (C.C.A.M.)

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.4.1-4
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• 1981

The statistical study was done on 74 cases of foreign bodies in the air passages, who visited the department of otolaryngology of SNUH during recent 5 years from 1975 to 1980. The result was as follows, 1) Of the total 74 cases, 55 cases were male and 18 cases were female. The ratio between male and female was 3 : 1. 41.8% of all-cases were under 2 years of age, 75.5% were under 3 years, and 83.6% were under 5 years. 2) Major symptoms on visit were dyspnea, cough, cyanosis. No significant symptoms was noted in 6.7%. Initial physical findings were coarse breathing sound, decreased breathing sound, and stridor. No abnormal physical findings were noted in 10.8%. 3) 48.6% of total cases visited hospital within 24 hours. There was one case who visited hospital over 2 years later. 4) Initial simple chest film showed atelectasis in 25.0%, emphysema in 32.8%, definite foreign body shadow in 17.2% and within normal limit in 17.2%. 5) 60.8% of total cases were vegetables, 15.5% were metals, 16.2% were fish bone, and 2.7 % were others. 6) Vegetables were most frequent foreign bodies in the cases under 5 years of age. 7) 40.5% of total cases were lodged in the right main bronchus, 31.0% were in the left main bronchus, 9.8% were in trachea and 6.7% were in multiple sites, 8) Foreign bodies were removed by ventilating bronchoscopy in 82.3%, by tracheostomy only in 2.7%, by tracheal suction in 2.7%, by spontaneous removal in 1.3%, by thorachotomy in 5.4% and 5.4% of total cases were expired.

• Speech Sciences
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• v.8 no.2
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• pp.23-37
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• 2001

The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

• The Journal of the Korean dental association
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• v.49 no.4
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• pp.219-226
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• 2011

Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

• Journal of Korean Academy of Nursing
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• v.23 no.4
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• pp.569-584
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• 1993

This study was done to verify validity of nursing diagnoses related to difficulty in respiratory function. First, content validity was examined by an expert group considering the etiology and the signs / symptoms of three nursing diagnoses - ineffective airway clearance, ineffective breathing pattern, impaired gas exchange. Second, clinical validity was examined by comparing the frequencies of the etiologies and signs / symptoms of the three nursing diagnoses in clinical case studies with the results of the content validity. This study was a descriptive study. The sample consisted of 23 experts (professors, head nurses and clinical instructors) who had had a variety of experiences using nursing diagnoses in clinical practice, and 102 case reports done by senior student nurses of the college of nursing of Y-university. These reports were part of their clinical practice in the ICU. The instrument used for this study was a checklist for etiologies and signs and symptoms based on the literature, Doenges and Moorhouse (1988), Kim, McFarland, McLane (1991), Lee Won Hee et al. (1987), Kim Cho Ja et at. (1988). The data was collected over four month period from May 1992 to Aug. 1992. Data were analyzed using frequencies done with the SPSS / PC＋ package. The results of this study are summarized as follows : 1. General Characteristics of the Expert Group A bachelor degree was held by 43.5% and a master or doctoral degree by 56.5% of the expert group. The average age of the expert group was 35.3 years. Their average clinical experience was 9.3 years and their average experience in clinical practice was 5.9 years. The general characteristics of the patients showed that there were more women than men, that the age range was from 1 to over 80. Most of their medical diagnoses were diagnoses related to the respiratory. system, circulation or neurologic system, and 50% or more of them had a ventilator with intubation or a tracheostomy. The number of cases for each nursing diagnoses was : · Ineffective airway clearance, 92 cases. · Ineffective breathing pattern, 18 cases. · Impaired gas exchange, 22 cases. 2. The opinion of the expert group as to the classification of the etiology, and signs and symptoms of the three nursing diagnoses was as follows : · In 31.8% of the cases the classification of etiology was clear. · In 22.7%, the classification of signs and symptoms was clear. · In 17.4%, the classification of nursing interventions was clear. 3. In the expert group 80% or mere agreed to ‘dysp-nea’as a common sign and symptom of the three nursing diagnoses. The distinguishing signs and symptoms of (Ineffective airway clearance) were ‘sputum’, ‘cough’, ‘abnormal respiratory sounds : rales’. The distinguishing sings and symptoms of (Ineffective breathing pattern) were ‘tachypnea’, ‘use of accessory muscle of respiration’, ‘orthopnea’ and for (Impaired gas exchange) it was ‘abnormal arterial blood gas’, 4. The distribution of etiology, and signs and symptoms of the three nursing diagnoses was as follows : · There was a high frequency of ‘increased secretion from the bronchus and trachea’ in both the expert group and the case reports as the etiology of ineffective airway clearance. · For the etiologies for ineffective breathing pat-tern, ‘rain’, ‘anxiety’, ‘fear’, ‘obstructions of the tract, ca and bronchus’ had a high ratio in the ex-pert group and ‘decreased expansion of lung’ in the case reports. · For the etiologies for impaired gas exchanges, ‘altered oxygen -carrying capacity of the blood’ and ‘excess accumulation of interstitial fluid in lung’ had a high ratio in the expert group and ‘altered oxygen supply’ in the case reports. · For signs and symptoms for ineffective airway clearance, ‘dyspnea’, ‘altered amount and character of sputum’ were included by 100% of the expert group. ‘Abnormal respiratory. sound(rate, rhonchi)’ were included by a high ratio of the expert group. · For the signs and symptoms for ineffective breathing pattern. ‘dyspnea’, ‘shortness of breath’ were included by 100% of the expert group. In the case reports, ‘dyspnea’ and ‘tachypnea’ were reported as signs and symptoms. · For the sign and symptoms for impaired gas exchange, ‘hypoxia’ and ‘cyanosis’ had a high ratio in the expert group. In the case report, ‘hypercapnia’, ‘hypoxia’ and ‘inability to remove secretions’ were reported as signs and symptoms. In summary, the similarity of the etiologies and signs and symptoms of the three nursing diagnoses related to difficulty in respiratory function makes it difficult to distinguish among them But the clinical validity of three nursing diagnoses was established through this study, and at last one sign and symp-tom was defined for each diagnosis.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.917-923
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• 1995

For the purpose of analysis of clinical and pathological characteristics in mediastinal tumors and cysts, 82 patients with mediastinal tumors and cysts treated in the department of thoracic and cardiovascular surgery in Chosun University Hospital during the period from January 1978 to December 1994 were reviewed. There were 49 male and 33 female patients in the study. Age ranges from 10 months to 84 years, with the mean 37.2 years. Frequently encountered symptoms and signs were dyspnea[40.2% , abnormal breathing sound[37.8% , chest pain[35.7% , cough[26.8% , and 18.2% of patients were asymptomatic. The most frequent tumor was anterosuperior mediastinum [59.8% followed by middle[24.4% and posterior mediastinum[15.8% . The malignant tumors were found in 35 cases[42.7% . Successful removal of the mass was possible in all the benign mediastinal masses[57.3% . But in the malignant cases, the surgical removal was possible in 18 cases and other inoperable cases were treated by radiation and chemotherapy. The postoperative complications occurred in 9 cases. Usual complications were bleeding[4 cases , wound infection[3 cases , pneumothorax[1 case and vocal cord paralysis[1 case . In the pathologic viewpoint, teratodermoid tumors[22.0% were the most frequent tumor followed by thymomas[19.5 , benign cysts[15.8% , lymphomas[13.4% and neurogenic tumors[8.5% .

• Journal of Chest Surgery
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• v.9 no.2
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• pp.315-322
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• 1976

This report is a analysis of 72 cases of mediastinal tumors which are originated in mediastinum or probably metastasized from other organs, and classified on the basis of histopathological types. And all are experienced in the Depart. Thoracic and cardiovascular Surgery, National Medical Center from 1959 to April 1976. Among these cases, 58 cases were confirmed by histopathologically, and remained 14 cases were considered as mediastinal tumor by clinically and roentgenologically. In this series, dermoid cyst and teratoma was most frequent tumor among histopathologically confirmed cases(27.6%), and thymoma 20.7%, neurogenic tumors 17.2%, carcinoma 19%, lymphoid tumor 8.6% and others was 5.9%. The cases of not verified histopathologically were 14 cases. The main clinical symptoms were dyspnea on exertion or orthopnea (62.55%), productive or irritative cough (59.77%), decreased breathing sound (43. 09%). S.V.C syndromes was seen in 25.02%, and there were no definitive symptom in 4.2% of all cases. The main treatment method was surgical removal and irradiation therapy.